From WIP to AR: How Nymbl Helps O&P Practices Take the Friction Out of Billing
O&P practices run on increasingly complex reimbursement rules. Between evolving payer requirements, time-consuming authorizations, and spreadsheets that never quite match your reports, it’s easy for billing teams to feel like they’re constantly chasing issues instead of staying ahead of them.
In a recent 30-minute live demo webinar, our Solutions Engineer, Josh Black, walked through how O&P practices are using Nymbl to:
- Catch billing issues earlier in the workflow
- Reduce manual claim clean-up
- Track AR and payer performance in real time
- Cut down on repetitive form-filling and documentation tasks
This recap highlights the key takeaways from that session.
Why Nymbl Was Built in the First Place
Nymbl got its start in 2016 when founder Josh Lau was working inside an O&P practice and asked to evaluate replacement software. At the time, there was only one O&P-specific solution on the market. The practice was already on it, but it wasn’t evolving with their needs.
Like many early EHR and practice management systems, the software was built decades ago. That meant the practice had to adapt their workflows to fit the system, rather than using technology that supported the way they actually worked.
Nymbl was built to flip that dynamic:
- Cloud-based and mobile-first, so teams can work from anywhere
- Configurable workflows that evolve with the practice
- More automation and better visibility, without compromising on compliance or reimbursement
Today, more than 300 organizations rely on Nymbl. Together we support over 3 million patients and send more than 30,000 claims through the system each month.
What O&P Leaders Are Asking For
Earlier this year, we partnered with an independent healthcare research firm to better understand how O&P practice leaders think about their practice management systems.
A few themes stood out:
- Practices want to be more efficient and more profitable, not just “keep up”
- Complex reimbursements are a persistent barrier and getting more complex over time
- Billing and AR workflows are time-intensive and frustrating, with a direct impact on cash flow and sustainability
- Leaders are increasingly interested in automation, AI, and better data, as long as it actually fits their world
The demo focused on exactly that: how Nymbl helps practices reduce friction in billing and AR while improving visibility across the entire revenue cycle.
Catching Issues Before They Become Claim Problems
Josh started the demo in the patient chart, on purpose. Billing doesn’t start when the claim is created; it starts the moment a device or service is ordered.
Front-End Alerts in the WIP
Within Nymbl’s WIP (work-in-progress) view, users see alerts whenever something important is missing or out of alignment. For example:
- A specific HCPCS code + payer combination that always requires:
- A particular modifier
- An authorization on file
- A need for a qualifying diagnosis for a given code
Those rules can be configured at multiple levels:
- HCPCS level
- Payer + HCPCS level
- HCPCS + diagnosis combination
- And much more!
Once configured, Nymbl surfaces alerts on both the front end (while the order is in progress) and the back end (when it’s time to bill). The goal is to catch as much as possible before the claim ever hits the billing queue.
Staying Ahead of Authorizations and Code Changes
On the
prescription tracker/open WIP tracker, admin and billing teams can quickly see:
- Which prescriptions have authorizations that are about to expire
- Which authorizations have already expired
- Which prescriptions have had HCPCS changes after documentation or orders went out
That last piece is key for keeping peace between practitioners, admins, and billers. If a practitioner updates codes after an SWO has been sent, Nymbl automatically flags the admin team that new documentation is needed, before it becomes a problem at billing.
All of this upfront work is designed to ensure that when a biller opens a claim, they’re reviewing and sending—not rebuilding work from scratch.
Making the Claim Itself a One-Stop Shop
From the proof of delivery area, users can initiate billing. Nymbl immediately runs a quick check on the claim and flags common issues, such as:
- Missing diagnosis codes
- Missing modifiers
- Items that are on the way but not reconciled
- Items that have been requested but not yet ordered
- And more!
Once a claim passes those checks and lands in the claims queue, billers can:
- Sort and filter claims by status (e.g., “new” or “assigned to me”)
- Bulk submit cleaned claims
- Jump directly into the claim or the chart via live links
1500 Form Defaults by Payer
Inside the claim, the goal is to give billers everything they need in one place. One of the biggest time-savers: Nymbl lets practices set CMS-1500 form defaults per payer.
That means fields like:
- Place of service
- Billing provider boxes
- Payer-specific requirements
- And more
can be configured so they auto-populate the way each payer wants to see them. For billers, that reduces guesswork, manual overrides, and constant back-and-forth between the clearinghouse and the EMR.
Working Smarter Inside the Claim
From a single claim screen, billers can:
- Verify and adjust diagnosis-to-code line assignments (e.g., left/right)
- Check alerts to confirm authorizations and add missing auth numbers
- View all related documents:
- Authorizations
- Delivery tickets
- Financial responsibility forms
- Other supporting files
If a delivery ticket was signed electronically, Nymbl will even warn the biller if the date of service doesn’t match the delivery ticket, while still allowing overrides when necessary.
In addition, billers can:
- Split codes when certain payers require individual lines for specific quantities
- Swap primary/secondary payers directly within the claim, even after a claim has been submitted
When a payer swap is needed, Nymbl handles the heavy lifting in the background: writing off the original claim, updating statuses, and generating a new claim so the biller doesn’t have to duplicate prescriptions or rebuild anything manually.
Automated Follow-Up and Real-Time Rules
Once claims are submitted to the clearinghouse via Waystar, Nymbl can automatically create follow-up tasks based on payer-specific rules. For example:
- Follow up sooner for commercial payers
- Use longer timelines for Medicare
- Customize intervals for high-risk or historically slow payers
Nymbl also offers an optional
real-time rules engine. Before claims even reach the clearinghouse, Nymbl can run internal checks and display a red warning box if there’s an issue with the submission data. Fixing issues here reduces clearinghouse rejections and clean-up work in Waystar later.
Turning AR Into a Daily Workflow (Not Just a Month-End Report)
On the AR side, Nymbl supports both:
- Historical AR reports (e.g., “where was AR at the end of January?”)
- An interactive Outstanding Balances module for day-to-day work
In the Outstanding Balances view, billing teams can:
- Generate a current snapshot of all outstanding balances
- Sort by aging bucket (e.g., 0–30, 31–60, 90+)
- Drill into AR by payer or work a raw list of claims
- Customize columns per user so each biller sees only the data they care about
Every column is sortable and filterable, and live links make it easy to:
- Open the claim
- Jump to the chart
- Add or review “last touch” notes
Claim responses for denied and rejected claims flow back in from Waystar and automatically update claim statuses and the AR module, so billers always know what needs attention.
Josh summed it up well: this is more than a static report—it’s a
working module that billers can live in all day.
Seeing the Bigger Picture With BI Dashboards
For leaders who want to understand trends without living in spreadsheets, Nymbl includes built-in BI dashboards via Amazon QuickSight, hosted on HIPAA-compliant infrastructure.
Out of the box, these dashboards allow practices to:
- Track what’s been billed and what’s been collected by month
- See how much AR remains from prior months (e.g., “Why has only 25% of August AR been collected?”)
- Identify top payers, who owes the most, and who pays the fastest or slowest
- View average days to pay by payer and spot bottlenecks
Instead of running multiple reports and stitching them together, leaders can open a dashboard and immediately see where to focus.
Payments, Crossovers, and the Little Things That Add Up
On the payment side, Nymbl integrates with Stripe so practices can:
- Take patient payments up front
- Store them as credits on the patient account
- Apply them seamlessly when insurance adjudicates, prompted at the time of posting
When payments come through Waystar, Nymbl imports:
- Line-level payments
- Line-level adjustments
- Patient EOB details
Nymbl also recognizes
electronic crossovers from Medicare to secondary payers. If a claim has already crossed over, Nymbl logs that and keeps it moving. If it hasn’t, the claim drops into a “send to secondary” bucket so nothing gets overlooked.
Cutting Down Time on Forms and Documentation
The last major area Josh highlighted was forms and documentation.
Beyond SWOs, ABNs, and financial responsibility forms (which Nymbl already supports and auto-calculates based on deductible and out-of-pocket amounts), many practices deal with:
- Payer-specific authorization forms
- Audit forms
- Repetitive billing forms and packets
- Clinical forms and measurement forms
- And anything else you can think of!
Nymbl’s custom forms feature is designed to eliminate manual form-filling wherever possible.
Here’s how it works:
- You take a form you already use (e.g., a pre-auth form in Word or PDF).
- You upload and configure it in Nymbl.
- When you open that form from a patient chart, Nymbl automatically pulls in known data:
- Patient demographics
- Insurance info
- Other mapped fields
If certain data doesn’t exist, those fields simply show as not available, and you can still use checkboxes, dropdowns, and free-text fields as needed. Completed forms can be:
- Saved back to the chart
- Faxed directly from Nymbl (if you’re using integrated eFax)
The net result: tasks that used to take 10–20 minutes per form can be reduced to a few clicks.
Ready to See It in Action?
Whether you want to reduce denials, tighten up AR, or give your billing team a cleaner workflow, we’d love to show you what’s possible. Book a live demo with us
here.
